A lesson in recovering from the unthinkable
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital By Sheri Fink Atlantic, 576pp, $29.99 WITH no running water or electricity and the back-up generators failing as dead bodies filled makeshift morgues, day four at the hospital resembled the frontlines of a war zone.
New Orleans in the wake of Hurricane Katrina, 33C in the shade, and the disaster inside Memorial shifted from horrible to horrific. While attempting to care for and evacuate more than 200 patients, the hospital’s staff listened to reports of prison breaks within the city, hostage situations and gangs with AK-47s roaming the drowned streets.
They heard gunshots outside the doors where, following the failure of the federal flood-protection system, water rose to inundate 80 per cent of the city.
To protect those inside, Memorial’s chief executive distributed firearms to security and maintenance members. They had undergone emergency drills before but, as Sheri Fink writes in Five Days at Memorial — part truecrime story and full-fledged inquiry into medical ethics amid infrastructure collapse — “no guidelines existed for this situation”.
“It’s like Night of the Living Dead,” said the city council president. Others sought biblical references (Noah, and Sodom and Gomorrah) or reached for analogies (“being simultaneously on the Titanic and in war”). Later, a chaplain searching for survivors compared Memorial to Dante’s The Divine Comedy.
Medicine dwindled by day two. Doctors changed the evacuation order, leaving the sickest for last.
By day five, after learning that not all of their patients would be rescued, some of those doctors euthanised the most critical in their care. “It was a desperate situation,” Fink writes, “and (one doctor) saw only two choices: quicken their deaths or abandon them.”
When members of a mortuary team arrived a week after the last living patients and staff members had left, 45 dead bodies lined the chapel, morgues, hallways and emergency room. Among them included 23 with elevated levels of morphine and other drugs in their systems — victims, forensic investigators believed, of homicide.
A doctor turned journalist, Fink received a 2009 Pulitzer Prize for her coverage of the events now expanded in this book. Besides offering a near play-by-play account of actions inside the hospital, the first half of the book gives backgrounds of the numerous personalities — doctors, nurses, staff, patients and family members — involved. Fink also provides context by relaying histories of triage and medical care, complete with its complex racial complications, in the American south.
The second half of Five Days at Memorial follows the lawyers and investigators who pursue allegations that in these chaotic days of the breakdown and sheer ineptitude of city, state and federal emergency services — as well as the hospital’s Dallas-based headquarters, more than 800km — two doctors and several nursing staff ended patients’ lives.
Fink pursues what unfolded at Memorial as one story — thankfully an exception rather than a rule among New Orleans’s hospitals during this time — in a city where thousands found themselves stranded on rooftops and thousands more waited in designated areas where authorities failed to provide drinking water, food or direction.
The list of local and federal failings that she catalogues, coupled with Fink’s professional understanding of the obligations and thoughtprocesses of the doctors and nurses, gives Five Days at Memorial the pace of a true-crime story in the vein of Truman Capote’s In Cold Blood. One of many differences, of course, is that those Kansas murders (a family of four in a population of 270) were an anomaly — whereas for years authorities had forewarned about the severity that New Orleans would face when (never if) a major hurricane struck the city.
Five Days at Memorial establishes a cast in which there are no good or evil players, only humans forced to act in extreme circumstances. Fink’s lack of bias prevents the reader from quick judgment. Most of all, her coverage — methodical though at times tedious — along with her drive to discern what went wrong, leads to the reader’s refusal to censure those forced to make unenviable decisions. In doing so, the book touches a readership beyond those interested in medicine or the destruction of New Orleans during and in the aftermath of Katrina.
Nearly 10 years after the storm, New Orleans — a city much more Caribbean than North American, more a sister to Havana than its southern equivalents of Atlanta or Houston — retains its image as a mecca of music and cuisine enjoyed around the world.
The case of Memorial, one blight on a perpetually blighted but resilient city, provides a primer in what not to do — and how to recover from the unthinkable. Fink’s record reminds us that we can learn more from our failures in such drastic times than from our successes, and how we can remain human during the most inhuman catastrophes. Kevin Rabalais is a writer and critic. A long-time New Orleans resident, he now lives in Melbourne.